There have been used bifurcated stent grafts for treating abdominal aortic aneurysms. Such stent grafts include a tubular body to extend in the aorta towards the renal arteries of a patient and usually a shorter leg and a longer leg with, once the bifurcated graft is deployed, an extension leg provided to extend down one iliac artery from the shorter leg with the longer leg extending down the other iliac artery.
In some cases of aneurysm, however, the aneurysm extends beyond the aortic bifurcation and down one at least of the iliac arteries. In such cases a separate branched iliac stent graft is deployed in the common iliac artery to allow for blood flow into the internal iliac and down the external iliac artery from the common iliac artery. There remains, however, the problem of connecting this branched iliac stent graft with the bifurcated stent graft in the aortic region.
It is to provide an extension for such an arrangement that the present invention is directed.
A particular problem with stent grafting in the common iliac region is that there is only a relatively short distance distally of the aortic bifurcation in which to make a connection and it is desirable that as secure as possible connection is provided.
Branched iliac stent grafts for use with the present invention are described in two U.S. Provisional Patent Applications. U.S. Provisional Patent Application Ser. No. 60/686,252, filed Jun. 1, 2005 entitled “Iliac Artery Stent Graft” discloses a side branch stent graft having a main tubular body and a tubular side branch that is affixed into the main tubular so that the lumen of the side branch is in fluid communication with the lumen of the main body. External zig-zag stents are on the main body proximal and distal the side branch. At least one internal zig-zag stent is at the distal end of the main body. A reinforcing ring is around the proximal end of the main body and stitched thereto. This feature and other features disclosed in U.S. Provisional Patent Application Ser. No. 60/686,252 could be used with the present invention, and the disclosure of U.S. Provisional Patent Application Ser. No. 60/686,252 is herewith incorporated in its entirely into this specification.
U.S. Provisional Patent Application Ser. No. 60/838,776 filed on Aug. 18, 2006 herewith and entitled “Configuration of Branched Stent Grafts” discloses a stent graft with at least two adjacent fenestrations in a tubular body. A tube extends into the body from each of the at least two fenestrations. The tubes are joined and open into a single larger tube within the tubular body. The teaching of this patent specification is incorporated in the present application in its entirety.
Typical branched aortic bifurcation stent grafts are described in PCT Patent Publication No. WO 98153761 entitled “A Prosthesis And A Method and Means of Deploying A Prosthesis” discloses an introducer for a prosthesis which retains the prosthesis so that each end can be moved independently. These features and other features disclosed in PCT Patent Publication No. WO 98153761 could be used with the present invention and the disclosure of PCT Patent Publication No. WO 98153761 is herewith incorporated in its entirety into this specification.
U.S. patent application Ser. No. 10/396,676, filed Mar. 25, 2003, and published on Oct. 23, 2003, as U.S. Patent Application Publication No. US-2003-01 99967-A1, and PCT Patent Publication No. WO 2003-0821 53 entitled “Bifurcated Branch Vessel Prosthesis” disclose a stent graft with a fenestration in the tubular wall thereof. A tube extends from the fenestration into the main lumen and is in fluid communication therewith. An extension leg stent graft can be deployed from a branch vessel into the fenestration to seal in the tube. A flared guide associated with the fenestration can be provided interiorly or exteriorly. This feature and other features disclosed in U.S. Patent Application Publication No. US-2003-0199967-A1, and PCT Patent Publication No. WO 2003-0821 53 could be used with the present invention, and the disclosure of U.S. Patent Application Publication No. US-2003-01 99967-A1, and PCT Patent Publication No. WO 2003-0821 53 is herewith incorporated in its entirety into this specification.
U.S. Provisional Patent Application Ser. No. 60/405,769, filed Aug. 23, 2002, U.S. patent application Ser. No. 10/645,095, filed Aug. 23, 2003, and published on Apr. 29, 2004, as U.S. Patent Application Publication No. US-2004-0082990-A1, and PCT Patent Publication No. WO 2004101 7867 entitled “Composite Prostheses” disclosed prostheses or stent grafts suitable for endoluminal deployment These prostheses and other features disclosed in U.S. Provisional Patent Application Ser. No. 60/405,769, U.S. patent application Ser. No. 10/645,095, and U.S. Patent Application Publication No. US-2004-0082990-A1, and PCT Patent Publication No. WO 20041077867 could be used with the present invention and the disclosure of U.S. Provisional Patent Application Ser. No. 60/405,769, U.S. patent application Ser. No. 10/645,095, and U.S. Patent Application Publication No. US-2004-0082990-A1, and PCT Patent Publication No. WO 2004/017867 is herewith incorporated in its entirely into this specification.
U.S. Pat. No. 6,695,875 entitled “Endovascular Stent Graft” discloses a main stent graft body and a separate attachment graft tube that extends proximally therefrom. The attachment graft tube has a proximal attachment stent for infrarenal attachment of the assembly to the aorta. These features and other features disclosed in U.S. Pat. No. 6,695,875 could be used with the resent invention and the disclosure of U.S. Pat. No. 6,695,875 is herewith incorporated in its entirety into this specification.
Throughout this specification the term distal with respect to a portion of the aorta, a deployment device or a prosthesis means the end of the aorta, deployment device or prosthesis further away in the direction of blood flow away from the heart and the term proximal means the portion of the aorta, deployment device or end of the prosthesis nearer to the heart. When applied to other vessels similar terms such as caudal and cranial should be understood.